Reality Check

MMIT Reality Check on Schizophrenia (Sep 2019)

September 13, 2019

According to our recent payer coverage analysis for schizophrenia treatments, combined with news from key healthcare influencers, market access is shifting in this drug landscape.

According to our recent payer coverage analysis for schizophrenia treatments, combined with news from key healthcare influencers, market access is shifting in this drug landscape.

To help make sense of this new research, MMIT’s team of experts analyzes the data and summarizes the key findings for you. The following are brief highlights. To read the full piece, including payer coverage, drug competition and prescriber trends, click here.

Payer Coverage: A review of market access for schizophrenia treatments shows that under the pharmacy benefit, about 39% of the lives under commercial formularies are covered without utilization management restrictions.

Trends: There is a shift towards more integration of Medicaid benefits into managed care contracts, as well as a slight decline in the use of carve-out financing.

MMIT Reality Check on Breast Cancer HER2+ (Sep 2019)

September 6, 2019

According to our recent payer coverage analysis for breast cancer (HER2+) treatments, combined with news from key healthcare influencers, market access is shifting in this drug landscape.

According to our recent payer coverage analysis for breast cancer (HER2+) treatments, combined with news from key healthcare influencers, market access is shifting in this drug landscape.

To help make sense of this new research, MMIT’s team of experts analyzes the data and summarizes the key findings for you. The following are brief highlights. To read the full piece, including payer coverage, drug competition and prescriber trends, click here.

Payer Coverage: A review of market access for breast cancer (HER2+) treatments shows that under the pharmacy benefit, about 32% of the lives under commercial formularies are covered with utilization management restrictions.

Trends: In July 2019, Amgen Inc. and Allergan plc launched oncology drugs Mvasi
(bevacizumab-awwb), an Avastin (bevacizumab) biosimilar, and Kanjinti (trastuzumab), a Herceptin (trastuzumab) biosimilar.

MMIT Reality Check on Dry Eye (Aug 2019)

August 30, 2019

According to our recent payer coverage analysis for dry eye treatments, combined with news from key healthcare influencers, market access is shifting in this drug landscape.

According to our recent payer coverage analysis for dry eye treatments, combined with news from key healthcare influencers, market access is shifting in this drug landscape.

To help make sense of this new research, MMIT’s team of experts analyzes the data and summarizes the key findings for you. The following are brief highlights. To read the full piece, including payer coverage, drug competition and prescriber trends, click here.

Payer Coverage: A review of market access for dry eye treatments shows that under the pharmacy benefit, about 40% of the lives under commercial formularies are covered with utilization management restrictions.

Trends: Contracting for preferred formulary status is expected to expand as new agents are approved. Many payers do not allow coverage for compounded products, so Klarity-C may have access issues.

MMIT Reality Check on Hemophilia A (Factor VIII) (Aug 2019)

August 23, 2019

According to our recent payer coverage analysis for hemophilia A (factor VIII) treatments, combined with news from key healthcare influencers, market access is shifting in this drug landscape.

According to our recent payer coverage analysis for hemophilia A (factor VIII) treatments, combined with news from key healthcare influencers, market access is shifting in this drug landscape.

To help make sense of this new research, MMIT’s team of experts analyzes the data and summarizes the key findings for you. The following are brief highlights. To read the full piece, including payer coverage, drug competition and prescriber trends, click here.

Payer Coverage: A review of market access for hemophilia A (factor VIII) treatments shows that under the pharmacy benefit, about 34% of the lives under commercial formularies are covered with utilization management restrictions.

Trends: PBMs are increasingly focused on offering high-touch condition management services that give them a more active role in patient care. For example, AscellaHealth, LLC harnesses a variety of resources to help better manage treatment for hemophilia.

MMIT Reality Check on Breast Cancer HER2- (Aug 2019)

August 16, 2019

According to our recent payer coverage analysis for breast cancer (HER2-) treatments, combined with news from key healthcare influencers, market access is shifting in this drug landscape.

According to our recent payer coverage analysis for breast cancer (HER2-) treatments, combined with news from key healthcare influencers, market access is shifting in this drug landscape.

To help make sense of this new research, MMIT’s team of experts analyzes the data and summarizes the key findings for you. The following are brief highlights. To read the full piece, including payer coverage, drug competition and prescriber trends, click here.

Payer Coverage: A review of market access for breast cancer (HER2-) treatments shows that under the pharmacy benefit, about 48% of the lives under commercial formularies are covered with utilization management restrictions.

Trends: In May 2019, the FDA approved Novartis’ Piqray (alpelisib) in combination with fulvestrant for the treatment of men and postmenopausal women with hormone receptor positive, human epidermal growth factor receptor-2 negative (HR+/HER2-), PIK3CA-mutated, advanced or metastatic breast cancer as detected by an FDA-approved test whose disease progressed on or after endocrine therapy.

MMIT Reality Check on Ulcerative Colitis (Aug 2019)

August 9, 2019

According to our recent payer coverage analysis for ulcerative colitis treatments, combined with news from key healthcare influencers, market access is shifting in this drug landscape.

According to our recent payer coverage analysis for ulcerative colitis treatments, combined with news from key healthcare influencers, market access is shifting in this drug landscape.

To help make sense of this new research, MMIT’s team of experts analyzes the data and summarizes the key findings for you. The following are brief highlights. To read the full piece, including payer coverage, drug competition and prescriber trends, click here.

Payer Coverage: A review of market access for ulcerative colitis treatments shows that under the pharmacy benefit, about 62% and 58% of the lives under commercial and health exchange formularies are covered with utilization management restrictions, respectively.

Trends: In April 2019, Highmark Inc. said it is targeting autoimmune diseases under a new outcomes-based contract with Takeda Pharmaceuticals U.S.A., Inc. for Entyvio (vedolizumab).